Smoking vs Vaping Before Surgery: What’s Worse – And How to Reduce Risks

When preparing for surgery, one of the most important things you can do to improve your recovery is to stop smoking or vaping. Many patients ask us: “Which is worse before surgery — smoking or vaping?” The truth is, both carry risks, though in slightly different ways.

Why smoking is a problem before surgery?
Smoking affects nearly every organ in your body, but for surgery it creates specific concerns:

  • Oxygen delivery: Carbon monoxide in cigarette smoke reduces oxygen in your blood.
  • Lung function: Smoking inflames your airways, increasing your risk of coughing, wheezing, or breathing complications after anaesthesia.
  • Wound healing: Nicotine and other chemicals constrict blood vessels, slowing healing and increasing infection risk.
  • Heart strain: Smoking raises blood pressure and heart rate, which can be dangerous during an operation.

The Australian and New Zealand College of Anaesthetists (ANZCA) highlights that smoking before surgery is linked to longer hospital stays, higher rates of complications, and poorer recovery.

What about vaping?
Vaping is sometimes thought of as a “safer” alternative, but research shows it isn’t risk-free — especially around surgery.

  • Nicotine exposure: Most e-cigarettes deliver nicotine, which has the same effects on wound healing and blood vessels as smoking.
  • Airway irritation: The vapour can inflame your lungs and throat, increasing the risk of coughing or breathing issues under anaesthesia.
  • Uncertainty of ingredients: Vapes can contain other chemicals that may affect the heart, lungs, or immune system.

ANZCA notes that vaping has not been studied as extensively as smoking, but the same precautions apply — it’s safest to stop before your procedure.

What you can do to reduce risks?
The good news is, stopping even for a short time makes a real difference. ANZCA and international guidelines recommend:

  • Stop as soon as possible — ideally 4–8 weeks before surgery, but even 24–48 hours can improve oxygen delivery and heart function.
  • Be honest with your anaesthetist — they can adjust your care plan if they know you smoke or vape.
  • Use supports if needed — nicotine replacement therapy (patches, lozenges, gum) and quit-smoking programs can double your chances of success.

Key Takeaways
Both smoking and vaping increase your risk of complications before and after surgery. The best step you can take is to stop — even temporarily — before your operation. 

Your anaesthetist and surgical team are there to help you reduce risks and recover safely.

References
ANZCA website: https://www.anzca.edu.au/patients

 

Armadale Anaesthesia
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